Mayo Test ID SPSM Morphology Evaluation (Special Smear), Blood
Necessary Information
1. Include complete blood count results, if available, with the specimen.
2. Reason for testing should be included with the specimen.
Specimen Required
Useful For
Detecting disease states or syndromes of the white blood cells, red blood cells, or platelet cell lines of a patient's peripheral blood
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| DIFFS | Morphology Eval (Special Smear) | No | Yes |
| SPSM_ | Special Smear | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PINTP | Peripheral Smear Interpretation | No | No |
| CBCN | CBC without Differential | Yes | No |
Testing Algorithm
If clinically abnormal results are identified by microscopic examination, a peripheral blood smear review is performed by a Hematopathologist at an additional charge.
If patient has not had a complete blood cell count in the last 3 days, one will be performed at an additional charge.
For more information see Acute Tickborne Disease Testing Algorithm.
Method Name
Manual-Microscopic Examination of Cells
Reporting Name
Morphology Eval (special smear)Specimen Type
Whole bloodSpecimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Ambient (preferred) | CARTRIDGE | |
| Refrigerated | CARTRIDGE | ||
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
| Clotted | Reject |
Clinical Information
Under normal conditions, the morphology and proportion of each blood cell type is fairly consistent in corresponding age groups. The morphology and proportion of each blood cell type may change in various hematologic diseases. Differential leukocyte count and special smear evaluation are helpful in revealing the changes in morphology or proportion of each cell type in the peripheral blood.
Reference Values
Relative Values:
1-3 years
Neutrophils/bands: 22-51%
Lymphocytes: 37-73%
Monocytes: 2-11%
Eosinophils: 1-4%
Basophils: 0-2%
Metamyelocytes: 0%
Myelocytes: 0%
4-7 years
Neutrophils/bands: 30-65%
Lymphocytes: 29-65%
Monocytes: 2-11%
Eosinophils: 1-4%
Basophils: 0-2%
Metamyelocytes: 0%
Myelocytes: 0%
8-13 years
Neutrophils/bands: 35-70%
Lymphocytes: 23-53%
Monocytes: 2-11%
Eosinophils: 1-4%
Basophils: 0-2%
Metamyelocytes: 0%
Myelocytes: 0%
Adults
Neutrophils/bands: 50-75%
Lymphocytes: 18-42%
Monocytes: 2-11%
Eosinophils: 1-3%
Basophils: 0-2%
Metamyelocytes: <1%
Myelocytes: <0.5%
Absolute Values:
Absolute Neutrophils
Males:
0-14 days: 1.60-6.06 x 10(9)/L
15 days-4 weeks: 1.18-5.45 x 10(9)/L
5 weeks-7 weeks: 0.83-4.23 x 10(9)/L
8 weeks-5 months: 0.97-5.45 x 10(9)/L
6 months-23 months: 1.19-7.21 x 10(9)/L
24 months-35 months: 1.54-7.92 x 10(9)/L
3-5 years: 1.60-7.80 x 10(9)/L
6-16 years: 1.40-6.10 x 10(9)/L
17 years: 1.80-7.20 x 10(9)/L
Adults: 1.56-6.45 x 10(9)/L
Females:
0-14 days: 1.73-6.75 x 10(9)/L
15 days-4 weeks: 1.23-4.80 x 10(9)/L
5 weeks-7 weeks: 1.00-4.68 x 10(9)/L
8 weeks-5 months: 1.04-7.20 x 10(9)/L
6 months-23 months: 1.27-7.18 x 10(9)/L
24 months-35 months: 1.60-8.29 x 10(9)/L
3-5 years: 1.60-7.80 x 10(9)/L
6-14 years: 1.50-6.50 x 10(9)/L
15-17 years: 2.00-7.40 x 10(9)/L
Adults: 1.56-6.45 x 10(9)/L
Absolute Lymphocytes
Males:
0-14 days: 2.07-7.53 x 10(9)/L
15 days-4 weeks: 2.11-8.38 x 10(9)/L
5 weeks-7 weeks: 2.47-7.95 x 10(9)/L
8 weeks-5 months: 2.45-8.89 x 10(9)/L
6 months-23 months: 1.56-7.83 x 10(9)/L
24 months-35 months: 1.13-5.52 x 10(9)/L
3-5 years: 1.60-5.30 x 10(9)/L
6-11 years: 1.40-3.90 x 10(9)/L
12-17 years: 1.00-3.20 x 10(9)/L
Adults: 0.95-3.07 x 10(9)/L
Females:
0-14 days: 1.75-8.00 x 10(9)/L
15 days-4 weeks: 2.42-8.20 x 10(9)/L
5 weeks-7 weeks: 2.29-9.14 x 10(9)/L
8 weeks-5 months: 2.14-8.99 x 10(9)/L
6 months-23 months: 1.52-8.09 x 10(9)/L
24 months-35 months: 1.25-5.77 x 10(9)/L
3-5 years: 1.60-5.30 x 10(9)/L
6-11 years: 1.40-3.90 x 10(9)/L
12-17 years: 1.00-3.20 x 10(9)/L
Adults: 0.95-3.07 x 10(9)/L
Absolute Monocytes
Males:
0-14 days: 0.52-1.77 x 10(9)/L
15 days-4 weeks: 0.28-1.38 x 10(9)/L
5 weeks-7 weeks: 0.28-1.05 x 10(9)/L
8 weeks-5 months: 0.28-1.07 x 10(9)/L
6 months-23 months: 0.25-1.15 x 10(9)/L
24 months-35 months: 0.19-0.94 x 10(9)/L
3-5 years: 0.30-0.90 x 10(9)/L
6-17 years: 0.20-0.80 x 10(9)/L
Adults: 0.26-0.81 x 10(9)/L
Females:
0-14 days: 0.57-1.72 x 10(9)/L
15 days-4 weeks: 0.42-1.21 x 10(9)/L
5 weeks-7 weeks: 0.28-1.21 x 10(9)/L
8 weeks-5 months: 0.24-1.17 x 10(9)/L
6 months-23 months: 0.26-1.08 x 10(9)/L
24 months-35 months: 0.24-0.92 x 10(9)/L
3-5 years: 0.30-0.90 x 10(9)/L
6-17 years: 0.20-0.80 x 10(9)/L
Adults: 0.26-0.81 x 10(9)/L
Absolute Eosinophils
Males:
0-14 days: 0.12-0.66 x 10(9)/L
15 days-4 weeks: 0.08-0.80 x 10(9)/L
5 weeks-7 weeks: 0.05-0.57 x 10(9)/L
8 weeks-5 months: 0.03-0.61 x 10(9)/L
6 months-23 months: 0.02-0.82 x 10(9)/L
24 months-35 months: 0.03-0.53 x 10(9)/L
3-11 years: 0.00-0.50 x 10(9)/L
12-17 years: 0.10-0.20 x 10(9)/L
Adults: 0.03-0.48 x 10(9)/L
Females:
0-14 days: 0.09-0.64 x 10(9)/L
15 days-4 weeks: 0.06-0.75 x 10(9)/L
5 weeks-7 weeks: 0.04-0.63 x 10(9)/L
8 weeks-5 months: 0.02-0.74 x 10(9)/L
6 months-23 months: 0.02-0.58 x 10(9)/L
24 months-35 months: 0.03-0.46 x 10(9)/L
3-11 years: 0.00-0.50 x 10(9)/L
12-17 years: 0.10-0.20 x 10(9)/L
Adults: 0.03-0.48 x 10(9)/L
Absolute Basophils
Males:
0-14 days: 0.02-0.11 x 10(9)/L
15 days-7 weeks: 0.01-0.07 x 10(9)/L
8 weeks-35 months: 0.01-0.06 x 10(9)/L
3-17 years: 0.00-0.10 x 10(9)/L
Adults: 0.01-0.08 x 10(9)/L
Females:
0-14 days: 0.02-0.07 x 10(9)/L
15 days-4 weeks: 0.01-0.06 x 10(9)/L
5 weeks-7 weeks: 0.01-0.05 x 10(9)/L
8 weeks-5 months: 0.01-0.07 x 10(9)/L
6 months-35 months: 0.01-0.06 x 10(9)/L
3-17 years: 0.00-0.10 x 10(9)/L
Adults: 0.01-0.08 x 10(9)/L
An interpretive report will be provided.
Interpretation
The laboratory will provide an interpretive report of percentage of white blood cells and, if appropriate, evaluation of white blood cells, red blood cells, and platelets.
Cautions
No significant cautionary statements
Clinical Reference
1. Kjeldsberg CR, eds. Practical Diagnosis of Hematologic Disorders. 5th ed. American Society of Clinical Pathologists; 2010
2. Weinberg SE, Behdad A, Ji P. Atypical lymphocytes in peripheral blood of patients with COVID-19. Br J Haematol. 2020;190(1):36-39
3. Pozdnyakova O, Connell NT, Battinelli EM, Connors JM, Fell G, Kim AS. Clinical significance of CBC and WBC morphology in the diagnosis and clinical course of COVID-19 infection. Am J Clin Pathol. 2021;155(3):364-375. doi:10.1093/ajcp/aqaa231
Method Description
Microscopic examination of a Wright-Giemsa-stained smear.(Unpublished Mayo method)
Day(s) Performed
Monday through Sunday
Report Available
1 to 2 daysSpecimen Retention Time
Slides: 1 yearPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
85007
85060-(if appropriate)
85027-(if appropriate)
88184-(If appropriate)
88185-(If appropriate)
88187-(if appropriate)
88188-(if appropriate)
88189-(if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SPSM | Morphology Eval (special smear) | 14869-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SEGBA | Neutrophilic Segs and Bands | 23761-0 |
| LYMPH | Lymphocytes | 26478-8 |
| MONOC | Monocytes | 26485-3 |
| EOS | Eosinophils | 714-6 |
| BASO | Basophils | 707-0 |
| META | Metamyelocytes | 740-1 |
| MYEL | Myelocytes | 749-2 |
| PROMY | Promyelocytes | 783-1 |
| UBLS | Blasts | 709-6 |
| PLSM | Plasma Cells | 79426-3 |
| M_KR | Megakaryocytes | 19252-6 |
| NUCL | Nucleated RBC | 19048-8 |
| FRAGC | Fragile Cells | In Process |
| BL_PR | Blasts and Promonocytes | In Process |
| MANC | Absolute Neutrophil | 753-4 |
| INT01 | Interpretation | 59466-3 |
| REV96 | Reviewed by: | 18771-6 |